Table: Strategies For Getting Your Costs Covered
ASKyour primary care doctor to write prescriptions for all therapies.
REQUEST the insurer to assign one case manager to work with you.
KEEP detailed, written records in case you need to appeal.
ASK for all denials of coverage in writing.
APPEAL denials to the insurer. All companies are required to have an appeals process.
MAINTAIN a separate file for your child's medical expenses. This helps if you want to deduct them from your federal income taxes (you can to the extent they exceed 7.5% of your adjusted gross income). This will also help your child qualify for Supplemental Social Security Income at age 18.
ASK human resources about company-specific benefits and assistance.
MAKE use of plans that allow you to put aside pretax dollars to cover medical expenses, such as medical, health savings, and flexible spending accounts.
IF NEEDS AREN'T COVERED, petition company to change health plan.
APPLY for Medicaid Waiver Program. It's available for children with disabilities even if their parents have too much money to qualify for Medicaid. There may be a co-pay based on the parents' income.
LOOK for a Catastrophic Illness in Children Relief Fund. Now, only New Jersey and Massachusetts have enacted such programs, but others are in the works. The plans allow any family to qualify for help if a child's unreimbursed medical and related expenses exceed 10% of the family's gross annual income up to $100,000, plus 15% of any portion over $100,000 (www.state.ma.us; www.state.nj.us).
FAMILIARIZE yourself with the Individuals with Disabilities Education Act, which mandates that each child receive "an appropriate education." For information, www.nichcy.org or www.ed.gov/about/ offices/list/osers/osep/index.html.
DON'T be shy. Ask the school to provide all necessary services to help your child learn.
CONSIDER hiring a private educational consultant to help secure services.
MAINTAIN frequent contact with teachers and school therapists. Keep detailed notes of all meetings.
EXPLORE out-of-district placement if a school is unable to meet your child's needs. Should the school refuse to supplement cost, consult an education attorney to discuss legal options.
FOR PRIVATE SCHOOL Apply for reimbursement for services under IDEA.
CONSIDER moving to a district or state that provides more special-needs support.